Author: Marian Chandler

Forty-three clinical research staff from 10 sites across Australia, attended training for the CHOICE UTI, SONIC, PROMPT Bolus, SENTINEL and PEACHY O and M studies.  This was held at the Centre for Children’s Health Research in Brisbane, on 2 and 3^rd of June 2022.

This was the first face to face training event held since pre-COVID times and by all accounts it was a great success! The meeting provided the opportunity to finally meet fellow colleagues in the research team and there is nothing quite like being able to ask questions and give answers in a face to face context!

Thanks to the organising team including: Marian Chandler, Amanda Williams, Sharon O’Brien, Natalie Phillips, Kate Klein, Elyssia Bourke and Cate Wilson.

Study of Neck Injury Imaging in Children (SONIC): Improving the Diagnosis of Spinal Cord, Bone and Ligament Injuries

Many children sustain head and neck trauma during their lifetime. Significant neck injuries – to spinal cord, neck bones and connecting ligaments – can be identified by performing neck imaging with x-rays, or, if needed, computed tomography or magnetic resonance imaging. Yet, it is unclear which children should receive neck imaging in the emergency department (ED), especially in the context of increasing concerns about radiation-induced cancer in children and the discomfort and delays of immobilisation prior to imaging.

This study aims to:

(i) investigate the accuracy of existing neck injury clinical decision rules (CDRs) to detect neck injuries in children (external validation) of adult focussed CDRs and the newly developed paediatric PECARN CDR
(ii) derive and validate a new CDR for neck imaging in children (the SONIC CDR),
(iii) assess the cost implications of different CDRs in children.
(iv) investigate the epidemiology of cervical spine injuries in ANZ.

Study design:

Multicentre, prospective observational study.

Timeframe:

2020 – 2025

Sites:

• Royal Children’s Hospital, Melbourne (VIC)
• Monash Children’s Hospital, Melbourne (VIC)
• Queensland Children’s Hospital (QLD)
• Logan Hospital (QLD)
• Sunshine Coast University Hospital (QLD)
• Gold Coast University Hospital (QLD)
• Perth Children’s Hospital, Perth (WA)
• Children’s Hospital at Westmead (NSW)
• Sydney Children’s Hospital (NSW)
• Women’s and Children’s Hospital, Adelaide (SA)
• Darwin Hospital (NT)
• Kids First, Auckland (NZ)
• Starship Children’s Hospital, Auckland (NZ)

Sample:

PREDICT ~30,000 (depending on prevalence of injuries), children aged <16 yrs with possible neck

News:

Recruitment has commenced at 8 Australian sites (Royal Children’s Hospital, Melbourne, Queensland Children’s Hospital, Perth Children’s Hospital, Women’s and Children’s Hospital, Adelaide and Darwin Hospital, Gold Coast and Sunshine Coast University Hospitals and Monash Hospital Victoria, with over 1000 patients enrolled to date.

Governance approvals are underway for the remaining 3 Australian sites with hopes to commence recruitment at these in the coming weeks. We are also awaiting final ethics approval for NZ and hope to commence site education and recruitment in the coming months and therefore having all 13 sites in full recruitment mode before the end of the year!

The PREDICT Executive finally met face face in Melbourne on June 15^th 2022 following over two years of the pandemic and travel restrictions.

Hopefully we will be able to have more meetings in person in the future, including our members meeting in October.

 

Congratulations to our Chair of PREDICT, Emergency Physician and the Director of Emergency Research, Professor Meredith Borland who has been named as a member of the Order of Australia (AM) in the Queen’s Birthday Honours List for her service to emergency medicine, particularly paediatrics and to medical research!

Professor Borland has been a member of PREDICT since its inception and is currently Chair of PREDICT for the past four years.  Over this time, she has made a huge contribution to our network’s development and research.  She has also undertaken several decades of research at the Emergency Department (ED) at PCH hospital. and built a reputation as a highly regarded national and international researcher in emergency research dating back to 2001.  Her world leading research has changed practice in emergency departments around the world.

We are delighted to see Professor Borland recognised with this richly deserved honour.

In case you missed this video recently, you can find out more about Professor Borland’s story here https://www.youtube.com/watch?v=ESqrLLUb4rE.

 

 

 

The Kids are Not Ok: Emergency Department management of acute mental health crises in children and young people – A retrospective study

Aim

Retrospective audit of medical records of children and young people below 18 years of age who presented to the ED with mental health concerns in 2018 (index presentation) and 1 year pre and post. The information will be used to describe, in different settings and types of EDs:

(a) current patterns and precipitants of ED mental health presentations;

(b) prevalence of co-morbid conditions;

(c) factors (including demographic, family and other social factors) associated with mental illness and suicidality; and

(d) the care provided within the ED and on follow-up.

Participants/Records

• All sites required to enter 100 patient records or as many as they have available.

Current status

Main Retrospective study

• So far as of 30.05.2022, we have 1427 complete entries.
• To date data entry has been completed by the following sites:
  • VIC – Austin hospital, University hospital Geelong, Frankston Hospital, Royal Children’s Hospital, Sunshine Hospital
  • QLD – Sunshine Coast University Hospital
  • WA – Perth Children’s Hospital, Albany Hospital
  • SA – Women’s and Children’s Hospital, North Adelaide
  • TAS – Royal Hobart hospital
• Data entry is currently progressing at the following sites:
  • VIC – Monash Health, Ballarat Base Hospital, Eastern Health
  • NT – Royal Darwin hospital
  • QLD – Gold Coast University Hospital
  • NSW – Tamworth Rural Referral Hospital

Covid retrospective study arm

• The COVID arm of the Retrospective study has commenced with data entry.
• Aiming to recruit 100 records from 2019 and 100 records from 2021 at each participating site.
• Data entry is currently progressing in VIC – Monash Health, Royal Children’s Hospital and TAS – Royal Hobart Hospital.
• So far as of 30.05.2022, we have 49 complete entries.

We are hoping to complete data collection for these studies by the end of August. Please let us know how you are going, and whether you might need a little more time.

 

The Kids are Not Ok: A Delphi Study to identify consensus research priorities and core outcome sets in paediatric emergency mental health presentations

Aim

• To determine a prioritised list of research questions and identify a set of core clinical and mental health outcomes for children and adolescents presenting to the ED with mental health concerns.

Participants

• Children/young people under 18 who attended ED with mental health concerns and their parents/carers.
• Doctors, nurses, mental health clinicians, police, paramedics, schoolteachers, school counsellors, hospital security.

Recruitment Status

• Commenced 2^nd of May 2022 and will continue to the 30^th of June
• Sites pending governance approval can join in recruitment process and project until mid-June, 2022.

Current Status

• As of 30.05.2022 – Complete Survey 1 responses received from healthcare/community-based services members = 57 (out of 103 survey response records), and complete Survey 1 responses from patient/carers = 8 (out of 29 survey response records).
• The participants are from:
  • VIC – Austin Health, Monash Health, Royal Children’s Hospital, Eastern Health, University Hospital Geelong-Barwon Health, Ambulance Victoria, Vic Police
  • SA – Women’s and Children’s Hospital, South Australia Ambulance
  • QLD – Gold Coast University Hospital, Queensland Ambulance Service
  • TAS – Royal Hobart Hospital
  • WA – WA school psychologist, WA police

 We are very keen to recruit more patients and families – please make an effort to approach them over the next month.

 

 

 

 

 

 

 

 

 

Aim:

To improve discharge communication currently provided to children presenting to the ED with mild head injuries and concussion. Specifically, adolescents who have an increased risk of post-concussion symptoms.

Design:

A mixed method, stepped co-design method to engage parents, youths and clinicians in the development of head injury discharge communication strategies.

Recruitment:

Co-design team recruited: 2 doctors, 1 nurse, 1 nurse practitioner, 4 parents, 3 youths.

Current Status:

• Ethics received from RCH and Western Health.
• Co-design team recruited and training materials developed.
• First meeting to brainstorm what needs to improve in discharge communication held in March 2022.
• Meeting 2 (prioritisation process) and Meeting 3 to develop strategies to improve discharge communication will be held late May/early June.
• A prototype will be developed following this meeting along with usability testing.

Our “Getting to Know You” segment ensures PREDICT members are aware of new members, their interests and areas of expertise and where they are located.

This month we introduce Dylan Mordaunt from the Southern Adelaide Local Health Network.

“I work as the Executive Director of the Women’s and Children’s Division of the Southern Adelaide Local Health, clinically as a paediatrician and as an Associate Professor for Flinders University.

My research interests primarily relate to health services research, including implementation science as well as population health research, particularly clinical epidemiology, health economic and outcomes research.”

Welcome to PREDICT Dylan.